Provider Demographics
NPI:1144281601
Name:NEIBERT, PETER JOSEPH (PHD)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:JOSEPH
Last Name:NEIBERT
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10068 ARMSTRONG ST
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:KY
Mailing Address - Zip Code:41091-7438
Mailing Address - Country:US
Mailing Address - Phone:859-384-3066
Mailing Address - Fax:
Practice Address - Street 1:10068 ARMSTRONG ST
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:KY
Practice Address - Zip Code:41091-7438
Practice Address - Country:US
Practice Address - Phone:859-468-3953
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYAT6412255A2300X
OHAT0024582255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer